Program_Memos / 2002 / AB-02-054

Article Overview

This program memorandum from CMS explains guidance for Medicare intermediaries, carriers, DMERCs, and standard system maintainers on outbound coordination-of-benefits transaction handling when incoming claim data does not meet required format or content expectations. It addresses the general conditions under which a compliant outbound X12N 837 COB transaction may be difficult to produce, along with the broader process implications for standard systems, data handling, and communication with trading partners. The article is relevant to billing, claims processing, and systems teams that support HIPAA-compliant electronic Medicare transactions.